Remote guidance

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Remote guidance, in the medical context, refers to the supervision or guidance of a medical task, usually a procedure or test, from a remote location. This falls in the realm of real time telemedicine applications. By way of example, a radiologist may guide an ultrasound examination from a remote location. As such, the proximate requisite expertise to accomplish a medical task is significantly diminished. In the previous example, a diagnostic quality ultrasound can be accomplished by non-medically trained individuals manipulating an ultrasound device located with the patient under guidance from a remote location. This is an example of teleradiology If appropriately configured, the remote guidance can originate from another room or floor in the same building, too as far away as another continent or even planet. NASA researchers have successfully demonstrated remote guidance of diagnostic level cardiac ultrasonography using ultrasound on the space station, non-medical astronauts performing the exam as guided by a terrestrially located expert.

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Remote diagnostics

Remote diagnostics refers to a real time telemedical application that achieves diagnostic level quality and information exchange. In this sense, it refers to an expectation for quality sufficient for making or excluding a medical diagnosis. In the telemedical context specific to radiologic images these images often are consistent with the DICOM standard. Given bandwidth issues universally plaguing the healthcare environment imagery beyond still images and brief video has not yet become standard expectation of care environments or PACS systems. Ultrasound scanning commonly utilized for abdomen, musculoskeletal, pelvis, gynecologic, cardiac and vascular evaluations has shown potential for remote diagnosis only of late.

More general Remote Diagnostics (RD) refers to detecting which fault or faults are present in a system, body of object, from a distance. Examples of use: aeroplanes, spacecraft, Formula 1 and major assets such as ships, trains etc. In cases where corrective actions are also made, the term 'Remote Diagnostic & Maintenance' is more appropriate.

Technical aspects

While still imagery can be e-mailed and forwarded in a multitude of methods, video product of medical devices has typically not been available for remote interaction. Recent improvements in scanning devices, for example ultrasound machines has facilitated this new capability. The inclusion of the VGA output gives the opportunity for frame grabber devices to stream such outputs to the internet.

Related Research Articles

Picture archiving and communication system Medical imaging technology

A picture archiving and communication system (PACS) is a medical imaging technology which provides economical storage and convenient access to images from multiple modalities. Electronic images and reports are transmitted digitally via PACS; this eliminates the need to manually file, retrieve, or transport film jackets, the folders used to store and protect X-ray film. The universal format for PACS image storage and transfer is DICOM. Non-image data, such as scanned documents, may be incorporated using consumer industry standard formats like PDF, once encapsulated in DICOM. A PACS consists of four major components: The imaging modalities such as X-ray plain film (PF), computed tomography (CT) and magnetic resonance imaging (MRI), a secured network for the transmission of patient information, workstations for interpreting and reviewing images, and archives for the storage and retrieval of images and reports. Combined with available and emerging web technology, PACS has the ability to deliver timely and efficient access to images, interpretations, and related data. PACS reduces the physical and time barriers associated with traditional film-based image retrieval, distribution, and display.

Medical ultrasound Diagnostic imaging technique

Medical ultrasound includes diagnostic imaging techniques, as well as therapeutic applications of ultrasound. In diagnosis, it is used to create an image of internal body structures such as tendons, muscles, joints, blood vessels, and internal organs. Its aim is usually to find a source of disease or to exclude pathology. The practice of examining pregnant women using ultrasound is called obstetric ultrasound, and was an early development of clinical ultrasonography.

Radiology Branch of Medicine

Radiology is the medical discipline that uses medical imaging to diagnose and treat diseases within the bodies of animals and humans.

Medical imaging Technique and process of creating visual representations of the interior of a body

Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to reveal internal structures hidden by the skin and bones, as well as to diagnose and treat disease. Medical imaging also establishes a database of normal anatomy and physiology to make it possible to identify abnormalities. Although imaging of removed organs and tissues can be performed for medical reasons, such procedures are usually considered part of pathology instead of medical imaging.

Echocardiography

An echocardiography, echocardiogram, cardiac echo or simply an echo, is an ultrasound of the heart. It is a type of medical imaging of the heart, using standard ultrasound or Doppler ultrasound.

Obstetric ultrasonography

Obstetric ultrasonography, or prenatal ultrasound, is the use of medical ultrasonography in pregnancy, in which sound waves are used to create real-time visual images of the developing embryo or fetus in the uterus (womb). The procedure is a standard part of prenatal care in many countries, as it can provide a variety of information about the health of the mother, the timing and progress of the pregnancy, and the health and development of the embryo or fetus.

Auscultation

Auscultation is listening to the internal sounds of the body, usually using a stethoscope. Auscultation is performed for the purposes of examining the circulatory and respiratory systems, as well as the alimentary canal.

Medical device Device to be used for medical purposes

A medical device is any device intended to be used for medical purposes. Medical devices benefit patients by helping health care providers diagnose and treat patients and helping patients overcome sickness or disease, improving their quality of life. Significant potential for hazards are inherent when using a device for medical purposes and thus medical devices must be proved safe and effective with reasonable assurance before regulating governments allow marketing of the device in their country. As a general rule, as the associated risk of the device increases the amount of testing required to establish safety and efficacy also increases. Further, as associated risk increases the potential benefit to the patient must also increase.

Design for testing or design for testability (DFT) consists of IC design techniques that add testability features to a hardware product design. The added features make it easier to develop and apply manufacturing tests to the designed hardware. The purpose of manufacturing tests is to validate that the product hardware contains no manufacturing defects that could adversely affect the product's correct functioning.

Sonographer

A sonographer is a healthcare professional who specialises in the use of ultrasonic imaging devices to produce diagnostic images, scans, videos or three-dimensional volumes of anatomy and diagnostic data. The requirements for clinical practice vary greatly by country. Sonography requires specialised education and skills to acquire, analyze and optimize information in the image. Due to the high levels of decisional latitude and diagnostic input, sonographers have a high degree of responsibility in the diagnostic process. Many countries require medical sonographers to have professional certification. Sonographers have core knowledge in ultrasound physics, cross-sectional anatomy, physiology, and pathology.

3D ultrasound Rendering technique in medical imaging

3D ultrasound is a medical ultrasound technique, often used in fetal, cardiac, trans-rectal and intra-vascular applications. 3D ultrasound refers specifically to the volume rendering of ultrasound data. When involving a series of 3D volumes collected over time, it can also be referred to as 4D ultrasound or real-time 3D ultrasound.

Myocardial perfusion imaging Nuclear medicine imaging method

Myocardial perfusion imaging or scanning is a nuclear medicine procedure that illustrates the function of the heart muscle (myocardium).

Abdominal ultrasonography

Abdominal ultrasonography is a form of medical ultrasonography to visualise abdominal anatomical structures. It uses transmission and reflection of ultrasound waves to visualise internal organs through the abdominal wall. For this reason, the procedure is also called a transabdominal ultrasound, in contrast to endoscopic ultrasound, the latter combining ultrasound with endoscopy through visualize internal structures from within hollow organs.

Dreamcast VGA

The Dreamcast VGA Box is an accessory for Sega's Dreamcast video game console that allows it to connect to a video display such as a computer monitor or a HDTV set through a VGA port. Because the Dreamcast hardware can produce a VGA-compatible video signal natively, this connection provides improved picture quality compared to standard composite video or S-Video connections, along with support for progressive scan video.

The Advanced Diagnostic Ultrasound in Microgravity (ADUM) project is a U.S. government-funded study investigating strategies for applying diagnostic telemedicine to space. The Principal Investigator is Scott Dulchavsky, Chairman of Surgery at the Henry Ford Health System. This study was the first formal experiment to examine the use of ultrasound in microgravity encompassing musculoskeletal, heart, lung, abdominal, pelvic, dental, and orbital scans. Ultrasound is the only medical imaging device currently available on board the International Space Station. In addition, the lack of physician expertise on board the ISS makes diagnosis of medical conditions challenging. Ultrasound may have direct application for the evaluation and diagnosis of hundreds of medical conditions and is of interest for treating exploration crews. The telemedicine strategies investigated by this project has widespread application on Earth in emergency and rural care situations. Ultrasound images from space from a variety of body regions have been shown to be of diagnostic quality and non-expert operators were easily trained in ultrasound skills. This work has been expanded to include professional Football, Baseball, and Ice Hockey teams as well as the Winter and Summer Olympic Games in collaboration with investigators such as Marnix Van Holsbeeck. Dr. Dulchavsky has also led an innovative pilot study to expand comprehensive ultrasound education to basic science medical students at the Wayne State University School of Medicine. This trial has been shown to be a success with over 82 percent of students agreeing or strongly agreeing that their educational experience with the lightweight ultrasound technology education was positive. This technology is now being taught to medical students in their clinical clerkships.

Epiphan Systems

Epiphan Systems, also known by its trade name as Epiphan Video, is an AV equipment manufacturer founded in Ottawa, Ontario, Canada with an office in Palo Alto, California.

Cardiac imaging

Cardiac imaging refers to non-invasive imaging of the heart using ultrasound, magnetic resonance imaging (MRI), computed tomography (CT), or nuclear medicine (NM) imaging with PET or SPECT. These cardiac techniques are otherwise referred to as echocardiography, Cardiac MRI, Cardiac CT, Cardiac PET and Cardiac SPECT including myocardial perfusion imaging.

Prehospital ultrasound is the specialized application of ultrasound by paramedics, to guide immediate care and treatment procedures. Like conventional ultrasound, it is a device that produces cyclic sound pressure to penetrate a medium (flesh) and reveal details about the inner structure of the medium.

Patient management software (PMS) is referred to as software that is regulated as a medical device. It is software that is used to acquire medical information from a medical device to be used in the treatment or diagnosis of a patient. It can also be software that is an adjunct to a medical device and directly contributes to the treatment of the patient by performing analysis, or providing treatment or diagnosis functionality that replaces the decision and judgment of a physician.

Doppler ultrasonography

Doppler ultrasonography is medical ultrasonography that employs the Doppler effect to generate imaging of the movement of tissues and body fluids, and their relative velocity to the probe. By calculating the frequency shift of a particular sample volume, for example, flow in an artery or a jet of blood flow over a heart valve, its speed and direction can be determined and visualized. Color Doppler or color flow Doppler is the presentation of the velocity by color scale. Color Doppler images are generally combined with grayscale (B-mode) images to display duplex ultrasonography images, allowing for simultaneous visualization of the anatomy of the area.

References

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